OBJECTIVES: In a multi-cohort phase 1/2 study (TRIDENT-1), repotrectinib, a next-generation tyrosine kinase inhibitor (TKI), has shown clinical activity and manageable safety in ROS1+ advanced non-small cell lung cancer (NSCLC) and NTRK+ locally advanced/metastatic solid tumors. We analyzed treatment-related symptoms and general health status in patients with NTRK+ solid tumors using the EORTC QLQ-C30
METHODS: Patients with NTRK+ advanced solid tumors who received either no prior TKI (TKI-naive) or ≤2 prior lines of TKI (TKI-pretreated) received repotrectinib 160 mg once daily for 14 days, followed by twice daily if tolerated. The QLQ-C30 was administered at screening, prior to each cycle, and end-of-treatment visit. Change from baseline in GHS/QOL and each of the functional and symptom scales/items were summarized. Time to first improvement (TFI) and time to definitive deterioration (TDD) were assessed using Kaplan-Meier methods. ≥10-point changes from baseline were prespecified as thresholds for meaningful change. Analysis was conducted on NTRK cohorts using data collected through December 2022.
RESULTS: Among the 79 patients with NTRK+ solid tumors (35 TKI-naïve [median follow-up: 17.8 months [range, 8.7–64.6]) and 44 TKI-pretreated (median follow-up: 20.1 months [8.7–69.4]) analyzed, the most frequent tumor type was NSCLC (43%). Mean baseline GHS/QOL scores were 70.2 in TKI-naïve and 64.9 in TKI-pretreated patients. Mean changes in GHS/QOL and functional scales were stable through the first year on treatment in both groups. Overall, symptom scales were stable, except worsening in Constipation for TKI-naïve. Median TDD in GHS/QOL was 17.5 (95% CI, 9.2–19.3) months for TKI-naïve and 13.1 (8.4–NE) months for TKI-pretreated. Median TFI in GHS/QOL was not reached for either group.
CONCLUSIONS: Patients with NTRK+ solid tumors who were treated with repotrectinib generally experienced stable HRQoL as measured by the QLQ-C30. These results compliment the efficacy and safety profile of repotrectinib as a treatment option for patients with NTRK+ solid tumors.